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<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en" dir="ltr">
<!-- begin head html zone file -->
<head>
	
	<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
	
		<title>Shipping Address</title>
		<meta http-equiv="Content-type" content= "text/html; charset=utf-8">
</head>
<body > 


		<form method="POST" name="frmBilltoShipto" class="frmshipto" action="https://quality-s.qvc.com/qic/qvcapp.aspx/view.1/app.multi/params.file.|Checkout|BilltoShipto,plex" >

			<div style="display:none;">
				<input type="hidden" name="NextURL" value="BilltoShipto.plex" />
				<input type="hidden" name="RefererForm" value="BilltoShipto" />
				<input type="hidden" name="ReturnToPage" value="" />
				<input type="hidden" name="LineNumber" value="" />
				<input type="hidden" name="LineTotal" value="" />
				<input type="hidden" name="Product" value="" />
				<input type="hidden" name="SpeedbuyInd" value="" />
				<input type="hidden" name="MemberNumber"  value="" />
				<input type="hidden" name="ReferenceCode" value="" />
				<input type="hidden" name="ProspectMemberNumber" value="" />
				<input type="hidden" name="PermShipToNickName" value="" />
				<input type="hidden" name="NewMemberSw" value="1" />
				<input type="hidden" name="SHIPTOSTANDARDIZEDSW" value="" />
				<input type="hidden" name="ABname" id="ABname" value="" />
				<input type="hidden" name="ABadd1" id="ABadd1" value="" />
				<input type="hidden" name="ABadd2" id="ABadd2" value="" />
				<input type="hidden" name="ABcity" id="ABcity" value="" />
				<input type="hidden" name="ABstate" id="ABstate" value="" />
				<input type="hidden" name="ABzip" id="ABzip" value="" />
				<input type="hidden" name="ABcounty" id="ABcounty" value="" />
				<input type="hidden" name="ABcountry" id="ABcountry" value="" />
				<input type="hidden" name="ABgeocode" id="ABgeocode" value="" />
				<input type="hidden" name="ABzipExtension" id="ABzipExtension" value="" />
				<input type="hidden" name="ShiptoABNickName" id="ShiptoABNickName" value="" />
				<input type="hidden" name="ShiptoCounty" id="ShiptoCounty" value="" />
				<input type="hidden" name="ShiptoGeocode" id="ShiptoGeocode" value="" />
				<input type="hidden" name="ShiptoZipExtension" id="ShiptoZipExtension" value="" />
				<input type="hidden" name="BilltoZipExtension" id="BilltoZipExtension" value="" />
				<input type="hidden" name="AddrBookSelected" id="AddrBookSelected" value="None" />				
				<input type="hidden" name="ShiptoLastName" id="ShiptoLastName" value="None" />
			</div>
			<!-- EGC section (Eric Rymers, 07/27/2005) -->
			<input type="hidden" name="OnlyElecGiftCards" value="0" />

			<!-- EGC section end -->

	
			<div class="fragTitle">New Account Information</div>
				<div class="formSeparator">
				<div id="createAccountText" class="createAccountText" style="visibility:hidden;">		                                                                
					<p>Start shopping! Create your QVC account and be among the first to hear about new items, special offers and upcoming shows. Your QVC account also allows you to receive order and shipping confirmations. When you sign up, you will receive an 8-digit account number.
					</div>
						<!-- begin overlay -->
							<div id="overlaywrap" style="display:none">	
								<div id="becomeMember"></div>
									<div class="clear"><!-- --></div>
							</div>
						  <!-- end overlay -->     
					</p><br>
							
					<fieldset>
					<ol>
						<li>
							<label><em>*</em> E-mail Address:</label>
							<input class="inputbox" type="text" name="EmailAddress" id="EmailAddress" size="25" value="" />
							<div id="reqEmail" class="labelerror" style="display:none;">E-mail Address is a required field</div>	
	
						</li>
						<li>
							<label><em>*</em> Confirm E-mail Address:</label>
							<input class="inputbox" type="text" id="EmailAddressVerify" size="25" value="" />
							<div id="reqCEmail" class="labelerror" style="display:none;">Confirm E-mail Address is a required field</div>
							<div id="noMatchEmail" class="labelerror" style="display:none;">Entered E-mail Addresses did not match</div>
						</li>
						<p>Please enter a 4-digit numeric PIN (Personal Identification Number) below. Please make a note of your PIN, as you will need it to access different QVC services.</p>
						<li>
							<label><em>*</em> PIN:</label>
							<input class="inputbox" type="password" name="Pin" id="Pin" size="4" value="" />
	
	
							<div id="reqCPIN" class="labelerror" style="display:none;">PIN must be entered twice for verification</div>
							<div id="noMatchPIN" class="labelerror" style="display:none;">Entered PIN values did not match</div>
						</li>
						<li>
							<label><em>*</em> Verify Your PIN:</label>
							<input class="inputbox" type="password" name="PinVerify" id="PinVerify" size="4" value="" />
						</li>
					</ol>
				</fieldset>
			</div>
			<div class="fragTitle">Billing Address</div>
			<div class="formSeparator">
	
				<fieldset>
					<ol>
						<li>
							<label><em>*</em> Title:</label>
							<select name="Prefix">
								<option value="06">Ms.</option>
								<option value="02">Mrs.</option>
								<option value="03">Miss</option>
								<option value="04">Dr.</option>
								<option value="01">Mr.</option>
								<option value="07">Mr/Mrs</option>
								<option value="08">Father</option>
								<option value="09">Sister</option>
							</select>
						</li>
						<li>
							<label><em>*</em> First Name:</label>
							<input class="inputbox" type="text" size="25" name="BilltoFirstName" id="BilltoFirstName" value="" />
							<div id="reqBtFirst" class="labelerror" style="display:none;">First Name is a required field</div>
						</li>  
						<li>
							<label><em>*</em> Last Name:</label>
							<input class="inputbox" type="text" size="25" name="BilltoLastName" id="BilltoLastName" value="" />
							<div id="reqBtLast" class="labelerror" style="display:none;">Last Name is a required field</div>
						</li>  
						<li>
							<label><em>*</em> Address Line 1:</label>
							<input class="inputbox" type="text" size="25" name="BilltoAddress1" id="BilltoAddress1" value="" />
							<div id="reqBtAddress" class="labelerror" style="display:none;">Address is a required field</div>
						</li>  
						<li>
							<label class="noem"> Address Line 2:</label>
							<input class="inputbox" type="text" size="25" name="BilltoAddress2" id="BilltoAddress2" value="" />
						</li>  
						<li>
							<label class="noem"> City:</label>
							<input class="inputbox" type="text" size="25" name="BilltoCity" id="BilltoCity" value="" />
						</li>  
						<li>
							<label class="noem"> State/Province:</label>
							<!--  -->
							<select name="BilltoState" id="BilltoState" class="inputbox">
									<option value="AL">Alabama</option>
								<option value="AK">Alaska</option>
								<option value="AS">American Samoa</option>
								<option value="AZ">Arizona</option>
								<option value="AR">Arkansas</option>
								<option value="AA">Armed Forces Americas</option>								
								<option value="AE">Armed Forces Europe</option>
								<option value="AP">Armed Forces Pacific</option>																
								<option value="CA">California</option>
								<option value="CO">Colorado</option>
								<option value="CT">Connecticut</option>
								<option value="DE">Delaware</option>
								<option value="DC">District of Columbia</option>
								<option value="FM">Federated States of Micronesia</option>
								<option value="FL">Florida</option>
								<option value="GA">Georgia</option>
								<option value="GU">Guam</option>
								<option value="HI">Hawaii</option>
								<option value="ID">Idaho</option>
								<option value="IL">Illinois</option>
								<option value="IN">Indiana</option>
								<option value="IA">Iowa</option>
								<option value="KS">Kansas</option>
								<option value="KY">Kentucky</option>
								<option value="LA">Louisiana</option>
								<option value="ME">Maine</option>
								<option value="MH">Marshall Islands</option>
								<option value="MD">Maryland</option>
								<option value="MA">Massachusetts</option>
								<option value="MI">Michigan</option>
								<option value="MN">Minnesota</option>
								<option value="MS">Mississippi</option>
								<option value="MO">Missouri</option>
								<option value="MT">Montana</option>
								<option value="NE">Nebraska</option>
								<option value="NV">Nevada</option>
								<option value="NH">New Hampshire</option>
								<option value="NJ">New Jersey</option>
								<option value="NM">New Mexico</option>
								<option value="NY">New York</option>
								<option value="NC">North Carolina</option>
								<option value="ND">North Dakota</option>
								<option value="MP">Northern Mariana Islands</option>
								<option value="OH">Ohio</option>
								<option value="OK">Oklahoma</option>
								<option value="OR">Oregon</option>
								<option value="PW">Palau</option>
								<option value="PA">Pennsylvania</option>
								<option value="PR">Puerto Rico</option>
								<option value="RI">Rhode Island</option>
								<option value="SC">South Carolina</option>
								<option value="SD">South Dakota</option>
								<option value="TN">Tennessee</option>
								<option value="TX">Texas</option>
								<option value="UT">Utah</option>
								<option value="VT">Vermont</option>
								<option value="VI">Virgin Islands</option>
								<option value="VA">Virginia</option>
								<option value="WA">Washington</option>
								<option value="WV">West Virginia</option>
								<option value="WI">Wisconsin</option>
								<option value="WY">Wyoming</option>
								<option value="AB">Alberta</option>
								<option value="BC">British Columbia</option>
								<option value="MB">Manitoba</option>
								<option value="NB">New Brunswick</option>
								<option value="NL">Newfoundland and Labrador</option>
								<option value="NS">Nova Scotia</option>
								<option value="NT">Northwest Territories</option>
								<option value="NU">Nunavut</option>
								<option value="ON">Ontario</option>
								<option value="PE">Prince Edward Island</option>
								<option value="QC">Québec</option>
								<option value="SK">Saskatchewan</option>
								<option value="YT">Yukon</option>

							</select>
						</li>  
						<li>
							<label><em>*</em> ZIP/Postal Code:</label>  <!-- JML 07/2008 change input box size from 10 to 6 -->
							<input class="inputbox" type="text" size="6" maxlength="6" name="BilltoZipCode" id="BilltoZipCode" value="" />
							<div id="reqBtZIP" class="labelerror" style="display:none;">ZIP/Postal Code is a required field</div>
	
						</li>						
						<li>
							<label><em>*</em> Country:</label>
							<select name="BilltoCountry">
	
								<option value="US" selected=&quot;selected&quot;> United States </option>
	
								<option value="CA"> Canada </option>
	
							</select>
						</li>						
						<li>
							<label><em>*</em> Home Phone:</label>
							<input class="inputbox" type="text" size="3" name="BilltoHpArea" id="BilltoHpArea" value="" />
							<input class="inputbox" type="text" size="3" name="BilltoHpExchange" id="BilltoHpExchange" value="" />
							<input class="inputbox" type="text" size="4" name="BilltoHpExt" id="BilltoHpExt" value="" />
							<div id="reqBtPhone" class="labelerror" style="display:none;">Home Phone is a required field</div>
	
						</li>						
						<li>
							<label class="noem">Work Phone:</label>
							<input class="inputbox" type="text" size="3" name="BilltoWpArea" id="BilltoWpArea" value="" />
							<input class="inputbox" type="text" size="3" name="BilltoWpExchange" id="BilltoWpExchange" value="" />
							<input class="inputbox" type="text" size="4" name="BilltoWpExt" id="BilltoWpExt" value="" />
						</li>						
					</ol>
				</fieldset>
				<input type="hidden" name="BilltoCounty" id="BilltoCounty" value="" />
				<input type="hidden" name="BilltoGeocode" id="BilltoGeocode" value="" />
			</div>
			<div class="fragTitle">Ship-To Address</span></div>
			<div class="formSeparator">
	
				<fieldset>
					<ol>
						<li>
							<label>Same as Bill-To:</label>  <!-- JML 07/2008 default checkbox setting -->
							<input type="checkbox" id="SameAsBilltoCheckbox" name="SameAsBilltoCheckbox" value="1" checked="checked" />
						</li>
					</ol>
				</fieldset>
				<div id="expandShipTo" style="display:none;">
					<p>To choose a Ship-To Address that is different than your Bill-To address, type in the name and address below.</p>
					<fieldset>
						<ol>
							<li>
								<label><em>*</em> Name:</label>
								<input class="inputbox" type="text" size="25" name="ShiptoFirstName" id="ShiptoFirstName" value="" />
								<div id="reqStFirst" class="labelerror" style="display:none;">Name is a required field</div>
							</li>  
							<li>
								<label><em>*</em> Address Line 1:</label>
								<input class="inputbox" type="text" size="25" name="ShiptoAddress1" id="ShiptoAddress1" value="" />
								<div id="reqStAddress" class="labelerror" style="display:none;">Address is a required field</div>
							</li>  
							<li>
								<label class="noem"> Address Line 2:</label>
								<input class="inputbox" type="text" size="25" name="ShiptoAddress2" id="ShiptoAddress2" value="" />
							</li>  
							<li>
								<label class="noem"> City:</label>
								<input class="inputbox" type="text" size="25" name="ShiptoCity" id="ShiptoCity" value="" />
							</li>  
							<li>
								<label class="noem"> State/Province:</label>
							<!--  -->
							<select name="ShiptoState" id="ShiptoState" class="inputbox">
									<option value="AL">Alabama</option>
								<option value="AK">Alaska</option>
								<option value="AS">American Samoa</option>
								<option value="AZ">Arizona</option>
								<option value="AR">Arkansas</option>
								<option value="AA">Armed Forces Americas</option>								
								<option value="AE">Armed Forces Europe</option>
								<option value="AP">Armed Forces Pacific</option>																
								<option value="CA">California</option>
								<option value="CO">Colorado</option>
								<option value="CT">Connecticut</option>
								<option value="DE">Delaware</option>
								<option value="DC">District of Columbia</option>
								<option value="FM">Federated States of Micronesia</option>
								<option value="FL">Florida</option>
								<option value="GA">Georgia</option>
								<option value="GU">Guam</option>
								<option value="HI">Hawaii</option>
								<option value="ID">Idaho</option>
								<option value="IL">Illinois</option>
								<option value="IN">Indiana</option>
								<option value="IA">Iowa</option>
								<option value="KS">Kansas</option>
								<option value="KY">Kentucky</option>
								<option value="LA">Louisiana</option>
								<option value="ME">Maine</option>
								<option value="MH">Marshall Islands</option>
								<option value="MD">Maryland</option>
								<option value="MA">Massachusetts</option>
								<option value="MI">Michigan</option>
								<option value="MN">Minnesota</option>
								<option value="MS">Mississippi</option>
								<option value="MO">Missouri</option>
								<option value="MT">Montana</option>
								<option value="NE">Nebraska</option>
								<option value="NV">Nevada</option>
								<option value="NH">New Hampshire</option>
								<option value="NJ">New Jersey</option>
								<option value="NM">New Mexico</option>
								<option value="NY">New York</option>
								<option value="NC">North Carolina</option>
								<option value="ND">North Dakota</option>
								<option value="MP">Northern Mariana Islands</option>
								<option value="OH">Ohio</option>
								<option value="OK">Oklahoma</option>
								<option value="OR">Oregon</option>
								<option value="PW">Palau</option>
								<option value="PA">Pennsylvania</option>
								<option value="PR">Puerto Rico</option>
								<option value="RI">Rhode Island</option>
								<option value="SC">South Carolina</option>
								<option value="SD">South Dakota</option>
								<option value="TN">Tennessee</option>
								<option value="TX">Texas</option>
								<option value="UT">Utah</option>
								<option value="VT">Vermont</option>
								<option value="VI">Virgin Islands</option>
								<option value="VA">Virginia</option>
								<option value="WA">Washington</option>
								<option value="WV">West Virginia</option>
								<option value="WI">Wisconsin</option>
								<option value="WY">Wyoming</option>
								<option value="AB">Alberta</option>
								<option value="BC">British Columbia</option>
								<option value="MB">Manitoba</option>
								<option value="NB">New Brunswick</option>
								<option value="NL">Newfoundland and Labrador</option>
								<option value="NS">Nova Scotia</option>
								<option value="NT">Northwest Territories</option>
								<option value="NU">Nunavut</option>
								<option value="ON">Ontario</option>
								<option value="PE">Prince Edward Island</option>
								<option value="QC">Québec</option>
								<option value="SK">Saskatchewan</option>
								<option value="YT">Yukon</option>

							</select>
							</li>  
							<li>
								<label><em>*</em> Postal Code:</label>  <!-- JML 07/2008 change input box size from 10 to 6 -->
								<input class="inputbox" type="text" size="6" maxlength="6" name="ShiptoZipCode" id="ShiptoZipCode" value="" />
								<div id="reqStZIP" class="labelerror" style="display:none;">ZIP/Postal Code is a required field</div>
	
							</li>						
							<li>
								<label><em>*</em> Country:</label>
								<select name="ShiptoCountry" id="ShiptoCountry">
	
									<option value="US" selected=&quot;selected&quot;> United States </option>
	
									<option value="CA"> Canada </option>
	
								</select>
							</li>
							<div class="billRadio">
								<p>Use this address for:<br />
									<input type="radio" name="ShiptoRadiobutton" value="ThisOrderOnly" checked="checked" /> <strong>This order only</strong> <br />
									<input type="radio" name="ShiptoRadiobutton" value="PermanentShipto" /> <strong>All future orders</strong> (Permanent Ship-To)**
								</p>
								<p>** To edit your permanent ship-to address or make any changes in the future, please access your Address Book in "My Account."</p>
							</div>
						</ol>
					</fieldset>
				</div>
				<div class="formButtons">
					<fieldset>
						<ol>
							<li>
							<label><em>*</em> Required Fields</label>
							<div class="buttonsDiv">
								<input type="image"  name="Continue"src="https://quality-s.qvc.com/pic/buttons/primary/continue_checkout.gif" alt="Continue Check-Out" />
								
									<a href="https://quality-s.qvc.com/qic/qvcapp.aspx/view.1/app.multi/params.file.|Checkout|BilltoShipto,plex.Command.CancelOrder.RefererForm.BilltoShipto"><img src="#" border="0" alt="Cancel Order" /></a>
								
							</div>
							</li>
						</ol>
					</fieldset>
				</div>   
			</div>

		</form>

</body>
</html>


